Therapeutic Use of Melatonin for Gastrointestinal Motility and Hypersomnolence in a Patient With Pineal Cyst Pathology

BACKGROUND Pineal gland cysts are believed to alter the production and release of melatonin, which can impact the sleep/wake cycle and gastrointestinal motility. The optimal management and treatment strategies for benign symptomatic pineal gland cysts are not yet fully determined. CASE REPORT This case report explores the effects of therapeutic melatonin supplementation on gastrointestinal (GI) motility and hypersomnolence in a 59-year-old woman with a benign pineal gland cyst. Melatonin was initiated and titrated based on response to 30 mg nightly. The patient experienced significant improvements in bowel movement regularity (improving from 1 every 5-7 days to daily) and hypersomnolence (reduction in number and dosage of stimulant medications and adverse effects) with this high-dose melatonin supplementation. Mood improvements in anxiety and depressive symptoms were also observed, with anxiety (GAD-7) scores experiencing a clinically significant decrease from the severe to moderate range. Amantadine and sertraline were used in conjunction with melatonin. This case highlights the potential broader implications and benefits of high-dose melatonin use in patients with symptomatic benign pineal gland cysts. CONCLUSIONS Treatment with high-dose melatonin was associated with improvements in hypersomnolence and GI motility. The report is limited by being a single case with lack of a control group, and use of concurrent medications. Larger, controlled studies are needed to further explore the mechanisms involved in the relationships between melatonin, GI functioning, and sleep dysregulation.